CASE REPORT   

Journal of Radiological Review 2021 June;8(2):164-7

DOI: 10.23736/S2723-9284.21.00107-5

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

A rare case of mixed adenoneuroendocrine carcinoma mimicking acute appendicitis

Chiara RINALDO ¹ ✉, Roberta BLASIO ¹, Michela TANGA ¹, Paola GAGLIARDI ¹, Dario GRIMALDI ², Fabio PINTO ¹

¹ Department of Radiology, Hospital of Marcianise, Caserta Health Authority, Caserta, Italy; ² Department of Radiology, Moscati Hospital, Caserta Health Authority, Aversa, Caserta, Italy

Mixed adeno-neuroendocrine carcinoma (MANEC) is an uncommon pathological diagnosis newly acknowledged by the World Health Organization in 2010. MANEC is a neoplasm with significant histological heterogeneity and characterized by the concurrent presence of both adenocarcinomatous and neuroendocrine differentiation. Here, we report the case of a 34-year-old woman presenting to our Emergency Department with severe abdominal pain, peritonism, marked neutrophilia, and anemia. In the suspicion of an acute appendicitis, the patient underwent an abdominal Ultrasound revealing in the right iliac fossa the presence of a hypo-anechoic lesion associated with a hyperechoic appearance of the neighboring perivisceral adipose tissue. Subsequently, a contrast-enhanced abdominal Computed Tomography was performed, showing a polylobed lesion, with peripheral contrast enhancement and hypodense central core, not dissociable from the last ileal loop and from the cecum. Abdominal surgery was then performed: the histological examination on the surgical sample proved a small cell neuroendocrine intestinal carcinoma with well differentiated adenocarcinoma’s areas.

KEY WORDS: Carcinoma, neuroendocrine; Adenocarcinoma; Colorectal neoplasms; Ultrasonography; Tomography, X-ray computed